Cotton buds should not be used to clean ears, health officials say.
Inserting a bud could damage the ear canal and eardrum and push wax further down, according to the health watchdog.
The draft guidance from the National Institute for Health and Care Excellence (Nice) also says that ear syringing, in which a large metal syringe is used to pump water manually into the ear to clear out wax, is potentially harmful and should no longer be used.
Experts say using cotton buds risks pushing wax further down the ear canal, which could lead to infections
Its committee agreed that buds may be a ‘hazard’ that can cause infections or push wax further into the ear canal.
The guideline says the ear canal is ‘self-cleaning’, with excess wax falling out on its own, and that the entrance to the ears can be cleaned with a damp flannel.
Rather than manual syringing, which can cause trauma, Nice recommends ‘ear irrigation’, in which an electronic machine pumps water safely into the ear at a controlled pressure to remove problem wax.
This can be done at GP surgeries and community clinics. Katherine Harrop-Griffiths, consultant in audiovestibular medicine and chairman of the guideline committee, said: ‘Ear irrigation is an effective method of removing earwax.
‘Ear drops should be used to soften the wax, either immediately before or for up to five days before the procedure.’
The Nice committee admitted there is a ‘lack of evidence’ on the risks associated with using cotton buds but that they present a ‘potential hazard’ when used by patients to remove wax themselves.
People have been warned not to use cotton buds to clean their ears as it may cause damage to the ear canal
They added: ‘The general advice given is not to insert anything into the ear canal as it is self-cleaning and the only cleaning needed is to gently wipe the conch of the external ear with a damp flannel over a finger.’
Wax can build up in the ear canal when someone has had surgery or used a hearing aid as well as if cotton buds have gone too deep.
The guideline, which has been put out for consultation until mid-January, also covers other issues linked to hearing loss.
Professor Mark Baker, director of the centre for guidelines at Nice, said: ‘Our draft recommendations can help improve care for people with hearing loss through better management of earwax and referring people with symptoms to the right service at the right time.’
Cotton buds have also proved controversial because of their plastic stems. They are one of the most common types of plastic waste found on beaches.
The current Wildlife Photographer of the Year exhibition at London’s Natural History Museum features a photo of a seahorse with its tail wrapped around one of the buds.